种植骨髓间充质干细胞的甲壳质人工神经修复周围神经缺损

Repair of nerve defects with de acetyl chitin nerve conduit perfused with mesen chymal stem cells

目的:骨髓间充质干细胞(bonemarrowstem,MSCs)在体外可以诱导分化为周围神经的许旺细胞,通过MSCs和生物降解支架材料复合后构建成的神经套管,探讨其桥接修复周围神经缺损的效果和MSCs的体内分化去向。方法:实验于2003-04/2004-02在北京大学人民医院创伤骨科实验室完成。培养纯化的成年大鼠MSCs,传代扩增。建立大鼠坐骨神经缺损的动物模型,缺损长度0.5cm,实验分3组,每组8只SD大鼠,各组均取右侧为实验侧,左侧为正常对照。A组:复合MSCs的甲壳质神经套管桥接组;B组:单纯神经套管桥接组;C组:造成神经缺损后原位神经移植组。术后4周和8周分别计算坐骨神经功能指数,行神经电生理和组织学检测评价疗效。结果:各组动物均有不同程度感觉和运动神经功能的恢复。术后8周各组的再生的神经纤维已越过套管缝合口,A,B,C组坐骨神经功能指数分别为45.2±1.32,54.2±1.47,66.5±1.40;运动神经传导速度分别为(36.10±3.71),(32.89±4.01),(25.45±3.78)m/s。上述各指标及远端神经轴突面积各组间比较均有:A组优于B组,B组优于C组,差异均有显著性意义(P<0.05)。结论:复合了MSCs的甲壳质神经套管修复周围神经缺损的效果优于单纯的甲壳质套管组,单纯套管组优于神经移植组。

AMI:Mesenchymal stem cells(MSC)in bone marrow could change into schwann cell in peripheral nerve in vitro.To study the effect of bridging nerve defect with de acetyl chitin nerve conduit perfused with mesenchymal stem cells(MSC)and t he differentiation fate of MSC in vivo. METHODS:The study was finished in the Department of Orthopaedics and Traumatol ogy,People’s Hospital of Peking University from April 2003 to February 2004.We cultured bone marrow mesenchymal stromal cells of purified adult rats, passaged and proliferated.Setted sciatic neurologic defect models in rats.24 SD rats were divided into 3 groups,with 0.5 cm defects in each right rear limb sciatic nerve 0.5 cm above the sciatic nerve bifurcation.Right lateral limb was chosen to be the experiment side and left side to be the control.The nerves were then repaire d in the following manner①Group A:De acetyl chitin nerve conduit bridging with perfused mesenchymal stromal cells;②Group B:simple conduit bridging;③Group C: Nerve graft in situ after neurologic defect.Sciatic nerve functional index(SFI), electrophysiological and histology studies were detected after 4th weeks and 8th week postoperative. RESULTS:Functional recovery of motor nerve and different degree of feeling was observed in each group.Regenerated nerve fiber in each group had crossed the su ture 8 weeks after operation.The SFI in A,B,C group was(45.2±1.32),(54.2±1.47) and (66.5±1.40).The motor nerve conduction velocity was(36.10 ±3.71),(32.89 ±4.01)and(25.45 ±3.78)m/s.There was significant difference of SFI,motor ne rve conduction velocity and distal axons acreage in the three groups,Group A was better than Group B(P< 0.05).Group B was better than Group C(P< 0.05). CONCLUSION:The effect of bridging nerve defects with de acetyl chitin nerve c onduit perfused with mesenchymal stem cells is better than simple conduit bridgi ng group,the simple conduit bridging is better than nerve graft in situ after ne urologic defect group.